Tags

Type your tag names separated by a space and hit enter

Morphologic and Functional Assessment of Photoreceptors After Macula-Off Retinal Detachment With Adaptive-Optics OCT and Microperimetry.
Am J Ophthalmol. 2020 06; 214:72-85.AJ

Abstract

PURPOSE

Limited information is available on morphologic and functional regeneration of photoreceptors after retinal detachment (RD) surgery. This observational clinical study compared morphologic and functional changes of cones after vitrectomy for macula-off retinal detachment.

DESIGN

Prospective, fellow-eye comparative case series.

METHODS

StudyPopulation: Five eyes after vitrectomy with gas for macula-off retinal detachment (retinal detachment eyes, RDE) and 5 healthy fellow eyes (HFE) of 5 patients (mean age 59.8 years, macula-off duration 0.5 days to 5.5 days). ObservationProcedures: Eyes were examined with adaptive-optics optical coherence tomography (AO-OCT), spectral-domain OCT (SDOCT), and microperimetry (MP) at 6 (baseline, BL) and 56 weeks (follow-up, FUP) after 23 gauge pars plana vitrectomy and SF6 gas tamponade. Eight corresponding regions at foveal eccentricities of 2.5° (ecc 2.5°) and 6.5° (ecc 6.5°) were analyzed in every eye. AO-OCT en face images and SD-OCT B-scans were graded regarding irregularity and loss of photoreceptor signals ranging from none to severe changes. The number of detectable cones at height of the inner-outer segment junction (IS/OS) and cone outer segment tips (COST) was counted manually in AO-OCT images. MP with a custom grid was used to assess retinal sensitivity at these locations. MainOutcomeMeasures: Cone density, cone pattern regularity and signal attenuation, retinal sensitivity.

RESULTS

In comparison to HFE, RDE showed highly irregular cone patterns in AO-OCT and irregular outer retinal bands in SDOCT. Despite significant improvement of cone pattern regularity compared to BL (P < .001), 63% of AO images showed remaining cone pattern irregularity and 45.5% of SDOCT B-scans showed severe signal reduction at FUP. In HFE, mean cone density retrieved from IS/OS and COST remained around 20,000/mm2 (ecc 2.5°) and 16,000/mm2 (ecc 6.5°) at BL and FUP. Cone density of RDE was significantly reduced and ranged between 200/mm2 and 15,600/mm2 (P < .001) at BL. Despite improvement at FUP (P < .001), mean cone density at IS/OS and COST was still lower compared to HFE and ranged between 7790 and 9555 cones/mm2 (P < .001). Mean retinal sensitivity of all measured locations remained 18 dB in HFE and was significantly lower in RDE, with 14.30 dB at BL and 14.64 dB at FUP. Both SDOCT grading and microperimetry sensitivity showed strong correlation with AO-OCT grading and cone density (rho values > 0.750).

CONCLUSIONS

The combination of AO-OCT, SDOCT, and microperimetry is a powerful tool to capture cone regeneration after vitreoretinal surgery. Our study shows that cone morphology and function improve within 56 weeks after RD surgery but structural and functional impairment is still present.

Authors+Show Affiliations

Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria.Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria.Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria.Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria.Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria.Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria.Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria.Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria.Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria. Electronic address: andreas.pollreisz@meduniwien.ac.at.Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

31883465

Citation

Reumueller, Adrian, et al. "Morphologic and Functional Assessment of Photoreceptors After Macula-Off Retinal Detachment With Adaptive-Optics OCT and Microperimetry." American Journal of Ophthalmology, vol. 214, 2020, pp. 72-85.
Reumueller A, Wassermann L, Salas M, et al. Morphologic and Functional Assessment of Photoreceptors After Macula-Off Retinal Detachment With Adaptive-Optics OCT and Microperimetry. Am J Ophthalmol. 2020;214:72-85.
Reumueller, A., Wassermann, L., Salas, M., Karantonis, M. G., Sacu, S., Georgopoulos, M., Drexler, W., Pircher, M., Pollreisz, A., & Schmidt-Erfurth, U. (2020). Morphologic and Functional Assessment of Photoreceptors After Macula-Off Retinal Detachment With Adaptive-Optics OCT and Microperimetry. American Journal of Ophthalmology, 214, 72-85. https://doi.org/10.1016/j.ajo.2019.12.015
Reumueller A, et al. Morphologic and Functional Assessment of Photoreceptors After Macula-Off Retinal Detachment With Adaptive-Optics OCT and Microperimetry. Am J Ophthalmol. 2020;214:72-85. PubMed PMID: 31883465.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Morphologic and Functional Assessment of Photoreceptors After Macula-Off Retinal Detachment With Adaptive-Optics OCT and Microperimetry. AU - Reumueller,Adrian, AU - Wassermann,Lorenz, AU - Salas,Matthias, AU - Karantonis,Maria Georgia, AU - Sacu,Stefan, AU - Georgopoulos,Michael, AU - Drexler,Wolfgang, AU - Pircher,Michael, AU - Pollreisz,Andreas, AU - Schmidt-Erfurth,Ursula, Y1 - 2019/12/25/ PY - 2019/08/30/received PY - 2019/12/11/revised PY - 2019/12/13/accepted PY - 2019/12/29/pubmed PY - 2019/12/29/medline PY - 2019/12/29/entrez SP - 72 EP - 85 JF - American journal of ophthalmology JO - Am. J. Ophthalmol. VL - 214 N2 - PURPOSE: Limited information is available on morphologic and functional regeneration of photoreceptors after retinal detachment (RD) surgery. This observational clinical study compared morphologic and functional changes of cones after vitrectomy for macula-off retinal detachment. DESIGN: Prospective, fellow-eye comparative case series. METHODS: StudyPopulation: Five eyes after vitrectomy with gas for macula-off retinal detachment (retinal detachment eyes, RDE) and 5 healthy fellow eyes (HFE) of 5 patients (mean age 59.8 years, macula-off duration 0.5 days to 5.5 days). ObservationProcedures: Eyes were examined with adaptive-optics optical coherence tomography (AO-OCT), spectral-domain OCT (SDOCT), and microperimetry (MP) at 6 (baseline, BL) and 56 weeks (follow-up, FUP) after 23 gauge pars plana vitrectomy and SF6 gas tamponade. Eight corresponding regions at foveal eccentricities of 2.5° (ecc 2.5°) and 6.5° (ecc 6.5°) were analyzed in every eye. AO-OCT en face images and SD-OCT B-scans were graded regarding irregularity and loss of photoreceptor signals ranging from none to severe changes. The number of detectable cones at height of the inner-outer segment junction (IS/OS) and cone outer segment tips (COST) was counted manually in AO-OCT images. MP with a custom grid was used to assess retinal sensitivity at these locations. MainOutcomeMeasures: Cone density, cone pattern regularity and signal attenuation, retinal sensitivity. RESULTS: In comparison to HFE, RDE showed highly irregular cone patterns in AO-OCT and irregular outer retinal bands in SDOCT. Despite significant improvement of cone pattern regularity compared to BL (P < .001), 63% of AO images showed remaining cone pattern irregularity and 45.5% of SDOCT B-scans showed severe signal reduction at FUP. In HFE, mean cone density retrieved from IS/OS and COST remained around 20,000/mm2 (ecc 2.5°) and 16,000/mm2 (ecc 6.5°) at BL and FUP. Cone density of RDE was significantly reduced and ranged between 200/mm2 and 15,600/mm2 (P < .001) at BL. Despite improvement at FUP (P < .001), mean cone density at IS/OS and COST was still lower compared to HFE and ranged between 7790 and 9555 cones/mm2 (P < .001). Mean retinal sensitivity of all measured locations remained 18 dB in HFE and was significantly lower in RDE, with 14.30 dB at BL and 14.64 dB at FUP. Both SDOCT grading and microperimetry sensitivity showed strong correlation with AO-OCT grading and cone density (rho values > 0.750). CONCLUSIONS: The combination of AO-OCT, SDOCT, and microperimetry is a powerful tool to capture cone regeneration after vitreoretinal surgery. Our study shows that cone morphology and function improve within 56 weeks after RD surgery but structural and functional impairment is still present. SN - 1879-1891 UR - https://www.unboundmedicine.com/medline/citation/31883465/Morphologic_and_Functional_Assessment_of_Photoreceptors_After_Macula_Off_Retinal_Detachment_With_Adaptive_Optics_OCT_and_Microperimetry_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9394(19)30616-6 DB - PRIME DP - Unbound Medicine ER -